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Click ‘Get Form’ to open the Felician Health Clearance Form in the editor.
Begin with Part I: General Information. Fill in your major, entry date, name, last four digits of your SSN, marital status, and contact details. Ensure all fields are completed accurately.
Move to Part II: History. Document any previous hospitalizations, surgeries, current medications, and allergies. This section is crucial for your health assessment.
In Part III: Physical Examination, ensure a licensed healthcare provider completes the findings. They will assess various health metrics and sign off on your ability to participate in academic and physical activities.
Complete Parts IV to VI regarding tuberculosis testing and immunizations. Attach necessary documentation as specified for compliance with New Jersey State law.
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A Medical Clearance Form is a document that certifies an individuals medical fitness for a particular activity or procedure. It usually includes a health history review, physical examination, and medical tests to ensure the patient is healthy enough to participate in the activity or undergo the procedure.
What do you need for a medical clearance?
Basic Evaluations: Without tests, it may take up to 12 days. Comprehensive Clearances: If lab tests or imaging studies are required, may take several days.
How much is the Felician University deposit?
Enrollment Form and Tuition Deposit To join the Felician Community you will need to submit a non-refundable $150 tuition deposit as soon as possible to secure your place in the program.
What is the purpose of a medical clearance?
Obtain Physical Examination: Obtain a physical exam for you and any accompanying EFMs from a licensed provider (i.e., a Physician Assistant, Nurse Practitioner, Doctor of Medicine, or Doctor of Osteopathic Medicine), who must complete and sign the DS-1843 /DS-1622 forms.
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enrollment prerequisite health form - Felician University
Personal History: List any previous hospitalizations, surgeries, major injuries, and chronic illnesses with dates (mo/yr). List all current medications. Include
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